Piedmont Healthcare is requiring patients who shoulder the entire cost of a non-emergency medical service to pay 25 percent of the bill before they get the care.<\/p>\n\n\n\n
The system\u2019s new upfront-payment policy was publicly revealed recently at the Healthcare Financial Management Association conference in Orlando. It was first reported by Modern Healthcare.<\/p>\n\n\n\n
The patients who will face the new charge fall into two categories: those who are uninsured and pay for their own care, and those who have insurance with high deductibles.<\/p>\n\n\n\n
Piedmont, a fast-growing nonprofit, operates 11 hospitals in Georgia.<\/p>\n\n\n\n
A Piedmont executive told GHN on Friday that the pay-upfront policy has existed at certain facilities for a couple of years, but now is system-wide.<\/p>\n\n\n\n
\u201cWe have plenty of room for exceptions [to the policy] based on patients\u2019 circumstances,\u2019\u2019 said Matt Gove, Piedmont\u2019s chief consumer officer. Uninsured patients automatically get a 70 percent discount, he said. \u201cWe have very robust financial aid for patients who don\u2019t have the ability to pay.\u2019\u2019<\/p>\n\n\n\n
The health system\u2019s $250.7 million bad-debt expense in fiscal 2018 was about 8 percent of its $3 billion in revenue that year \u2014 up from 6.5 percent of revenue the prior year and much higher than the 2 percent national average that the American Hospital Directory calculated in 2017, Modern Healthcare reported.<\/p>\n\n\n\n
\u201cWe\u2019ve seen patient liability grow significantly over the past three years,\u2019\u2019 said Gove, citing the increase of high-deductible insurance policies.<\/p>\n\n\n\n
The growth of those health plans \u2013 which trade lower premiums for higher deductibles \u2013 often creates situations in which patients have difficulty paying for medical services and hospitals struggle to collect unpaid bills.<\/p>\n\n\n\n
Among the 156 million Americans with health insurance through employers, 1 in 5 have deductibles of more than $3,000 for individuals and $5,000 for families, according to a May survey by the Kaiser Family Foundation.<\/p>\n\n\n\n
A Kaiser Foundation poll this month found that one-third of insured adults say it is either \u201cvery difficult\u201d or \u201csomewhat difficult\u201d for them to pay their deductible.<\/p>\n\n\n\n
Medical bills are an overwhelming problem for many families. The KFF poll found about one-fourth of U.S. adults say they or a household member have had problems paying medical bills in the past year, and about half of this group (12 percent of all Americans) say the bills had a major impact on their family.<\/p>\n\n\n\n
Nonprofit hospitals\u2019 bad debt, meanwhile, is expected to increase by 8 percent to 9 percent this year as health care plans place a greater financial burden on patients, according to Moody\u2019s Investors Service.<\/p>\n\n\n\n
The pay-upfront policy is often used by physicians\u2019 offices, according to industry experts, who add that Piedmont may be the first system in Georgia to have a system-wide policy for hospital services.<\/p>\n\n\n\n
Berneta Haynes of the consumer advocacy group Georgia Watch said Piedmont\u2019s pay-upfront policy \u201craises red flags\u2019\u2019 as a potential barrier for patients seeking medical care.<\/p>\n\n\n\n
The policy could deter some patients, forcing the uninsured and those with high deductibles to seek care elsewhere, she said.<\/p>\n\n\n\n
For the insured, their hospital networks \u2018\u2018can be so narrow that going to another hospital may not be feasible,\u2019\u2019 Haynes said.<\/p>\n\n\n\n
Deductibles have soared, she said, because the Affordable Care Act\u2019s rules on them have been weakened.<\/p>\n\n\n\n
Haynes said Georgia Watch wants to make sure that patients are made aware of discounts that are available and that nonprofit hospitals inform patients of their financial assistance programs, which are required under the ACA. She said Piedmont\u2019s providing that help will be crucial for many patients.<\/p>\n\n\n\n